My concerns have less to do with morality and more to do with reality. Private
clinics offer older mothers far better rates of conception at a point where
time is of the essence.

As I write this, my seven-year-old daughter is at school and my little boy, who is two, is at a playgroup that he attends a couple of afternoons a week. Although I’m 43, I’m not the oldest mother at the nursery gates. In fact, one of my friends had her now 18-month-old daughter at the age of 45. Like me, she had IVF – and, like me, it was the best money she ever spent, although after many failed attempts her final bill came to £46,000, whereas I was lucky second time around.

Neither of us was eligible to have treatment on the NHS but, more crucially, neither of us would have wanted to be treated by the NHS. Why? Because, quite simply, the league tables show that the best success rates are for private clinics, which treat more older women and so have greater expertise.

That’s why I have mixed feelings about the news that as well as same-sex couples, women over 40 who have never previously had infertility treatment, will soon be able to obtain it on the NHS.

I understand there will be those – the fortunate and the fertile – who object to the expansion of IVF funding at a time of austerity, when resources are stretched so thinly that nurses last week heckled the Health Secretary, Andrew Lansley. But infertility is recognised as a medical condition by the World Health Organisation and it ruins lives, destroys marriages and has a corrosive effect on mental health, leaving the NHS to pick up the pieces.

Enabling lesbians to have treatment is another flashpoint, but if unmarried heterosexual couples and single women can be treated there’s no logic in barring same-sex couples, whether in a civil partnership or not. Unplanned babies are conceived all the time in questionable circumstances, but I’ve yet to come across anyone who underwent IVF lightly, without thought to the consequences or the upbringing of the child who might result.

My concerns have less to do with morality and more to do with reality. While I’m pleased that women are no longer being arbitrarily discriminated against on the grounds of age – the current cut-off point is 39, which is being raised to 42 – I have a nagging fear that it could lead to false hope among those who, frankly, are trying to conceive against the clock.

My daughter was conceived naturally, but I resorted to IVF after four years of trying for another baby. By then I was 41 and desperate to complete my family. I work in management, so I took a very businesslike approach and did lots of research about success rates of various clinics before choosing one.

IVF and its sister treatment ICSI, in which a single sperm is injected into an egg, may not yet be entirely commonplace, but nearly 170,000 babies have been born as a result since 1991; and 2 per cent of children now born in Britain are conceived this way. Although the Human Fertilisation and Embryology Authority (HFEA) no longer publish straightforward league tables of results for clinics on their website, they do state that: “The majority of clinics perform around the national average.” But, in my experience, most especially for older women, this just isn’t true.

For example, at Burton Hospitals NHS Trust in Staffordshire, which accepts NHS patients, the success rate for women aged 40-42 is 10 per cent, which is below the national average of 12.9 per cent. Yet at the Assisted Reproduction and Gynaecology Centre (ARGC) in central London, which is exclusively for private patients, the success rate for women this age is 26.4 per cent – more than twice the national average. I know where I’d prefer to be treated.

As far back as 2007, a BBC investigation revealed that the likelihood of successful IVF treatment on the NHS was lowered because doctors were too overstretched to collect eggs and transfer the fertilised eggs back into the womb at the optimum time.

While procedures at many clinics have since been refined, the fact remains that the older the woman is, the smaller the likelihood of her getting pregnant, with or without fertility treatment. Current guidelines from the National Institute for Health and Clinical Excellence (Nice) state that up to three cycles of IVF or ICSI should be made available subject to certain criteria. A woman must be aged 23-39, have an identifiable cause of infertility and have had more than three years of fertility problems. But because Primary Care Trusts (PCTs) make decisions at local level, the number of cycles funded varies from region to region. Some PCTs also impose further hurdles such as a woman’s weight, whether she already has children and whether she has previously undergone fertility treatment. Others do not fund any IVF at all.

“The decision by Nice to widen eligibility for IVF is based on cost and clinical effectiveness, and it’s good news for the small number of women it will affect,” says Susan Seenan, deputy chief executive of Infertility Network UK. “But IVF treatment is still a postcode lottery and there are already vast numbers of people unable to access treatment.”

Current advice is for women to start a family in their twenties or early thirties. From the age of 35, fertility declines and continues to do so sharply. While a woman in her forties may still be producing eggs, the quality, and hence their viability, is reduced.

“Infertility is a huge source of anguish and sadness and has a devastating impact on some couples,” says Seenan. “The one thing that’s worse than finding out you can’t have a baby is finding out you can’t have the treatment you need because of where you live.”

According to the HFEA, the average birth rate per cycle of IVF is 32.5 per cent for women under 35, 28 per cent for women aged 35-37 and 20.2 per cent for those aged 38-39.

I was lucky enough to be able to afford two cycles of fertility treatment, but not without sacrifice. One cycle, including drugs, cost me around £6,000 when scans and additional tests are included, and I gave up my job in order to concentrate on getting pregnant. Was it worth it? Absolutely.

Lord Winston, an outspoken critic of what he sees as the commercialisation of fertility treatment, has welcomed the Nice guidelines but is unhappy about the prohibitive cost that is often involved. “I think this decision by Nice is not just perfectly reasonable but long overdue,” he says. “The nature of our society is that women are leaving child-bearing until later and later in life, and there are good reasons for it, too.

“A woman is much more likely to be a good mother at 40 than at 20, because she’s more mature and better off. I think the real scandal isn’t age but the cost of IVF. It’s not uncommon for it to cost £10,000, when the real cost is £2,000. It’s really rather shameful that nobody is standing up for the rights of women not to be exploited.”

Around 59 per cent of the 58,000 cycles of IVF carried out in 2010 were funded privately, the rest were funded by the NHS. The treatment is gruelling both physically and emotionally but, even with low odds, many couples will try again and again. For me, it was only after cradling my longed-for newborn baby in my arms after years of unhappiness that I realised the full extent of my previous misery.

The number of babies born to women aged 45 and over has almost trebled in the past decade from 663 in 2000 to 1,758 in 2010 (though a large proportion of the rise is due to egg donation).

Dr Mike MacNamee CEO of Bourn Hall Fertility Clinic, where IVF was pioneered by Dr Patrick Steptoe and Dr Robert Edwards, leading to the birth of the world’s first “test-tube” baby, Louise Brown, in 1978.

“At first glance it might seem tokenistic to give women over 40 just one IVF cycle, but the fact is that of the women who are going to get pregnant, you will get the majority of them pregnant the first time,” says Dr MacNamee. “There will be other women who have the potential to get pregnant but they will be tougher cases.

“I would have preferred a smarter strategy, where women could also have their ovarian reserve assessed to find out whether there is a chance they will get pregnant with their own eggs and then, if necessary and if wanted, they could have a cycle using donor eggs.”

Dr MacNamee’s clinic carries out 1,500 NHS cycles a year and has a high success rate, with 42 per cent of those patients getting pregnant on their first attempt. But he is adamant that there must be an ethical dimension to the baby-making business.

“I think it’s part of every IVF clinic’s job to carry out an assessment. Where it’s clear that a woman won’t get pregnant or stay pregnant, they need to help her look forward and consider her options – such as egg donation, adoption or a life without children.”